Hand motor activity, cognition, mood, and the rest-activity rhythm in dementia: a clustered RCT.
BACKGROUND
Physical activity such as walking may exert a positive impact on cognition and behaviour in older persons with dementia, but due to the frailty of the population it may be worthwhile to consider other motor activities as well.


OBJECTIVE
Examining the effects of hand motor activity on cognition, mood and the rest-activity rhythm in older persons with dementia.


METHODS
Sixty-one older nursing home residents with dementia (mean age 84.6 years) were randomly assigned to either a hand movement program (experimental) or read aloud program (control) for 30min, 5 days a week, during 6 weeks. Neuropsychological tests, mood questionnaires, and actigraphy data were assessed at baseline, after 6 weeks, and again after 6 weeks. Apolipoprotein epsilon (ApoE) genotype was determined.


RESULTS
Scores on neuropsychological tests were combined and formed specific Cognitive domains. Symptoms of depression and anxiety formed the Mood domain. Actigraphy variables composed the Rest-activity domain. In mixed model analyses no significant group x time interactions were found on either the Cognitive, Mood or Rest-activity domains in the intention-to-treat analysis. In the per protocol analysis, that included people who attended at least 80% of the sessions, mood improved only in the experimental group. No significant time x group x ApoE interaction effects were found in either analysis.


CONCLUSIONS
In older nursing home residents with dementia, increased attendance to the hand movement program appeared to have a positive effect on mood. Hand motor activity is a type of activity that can be applied at a large scale.
Eggermont
Laura H P
LH
VU University, Department of Clinical Neuropsychology, Amsterdam, The Netherlands. LHP.Eggermont@psy.vu.nl
Knol
Dirk L
DL
Hol
Elly M
EM
Swaab
Dick F
DF
Scherder
Erik J A
EJ
D000339:Affect / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D001057:Apolipoproteins E / Q000235:genetics; D016000:Cluster Analysis; D003071:Cognition / Q000502:physiology*; D003704:Dementia / Q000235:genetics / Q000523:psychology*; D003863:Depression / Q000523:psychology; D004493:Education; D005260:Female; D005838:Genotype; D006225:Hand / Q000502:physiology*; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D009043:Motor Activity / Q000502:physiology*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000502:physiology; D021641:Recognition, Psychology / Q000502:physiology; D012146:Rest / Q000502:physiology
D001057:Apolipoproteins E